Applying for Optional Benefits
Under your group insurance program, an employee is eligible to apply for optional life insurance.
Optional life benefit
1. Employee must complete the Optional Group Life Insurance Application Form
2. Keep a photocopy of the forms for your records and mail the original copies of the forms to the insurer for processing
Note: Since optional life requires evidence of insurability, the employee and/or his/her spouse may be asked to undergo additional medical examinations. Optional life is
NOT approved until the employee is notified in writing by the insurer. All approved optional life amounts will be added to your billing statement by the insurer.
Changing Smoking Status
1. If an employee has optional life coverage and changes from a smoker to a non-smoker (thereby affecting the rates for the Optional Life Insurance coverage), please have the employee complete the Smoking Status Declaration Form
2. Mail the original form to the insurer
3. Retain a photocopy for your files
Note: The insurer will record the applicable changes on your premium statement.
Please be advised that a non-smoker is defined as someone who has not used smoking materials
(cigarettes, cigars, pipes, nicotine gum or patch, etc.) or used tobacco in any other form
within the last 12 months.
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Last updated on: July 23, 2012 Page:
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